Failure of pandemic preparedness: look in the mirror [rant alert]

The AP's Margie Mason is a pretty good flu reporter and she has a story on the wires today whose title encapsulates the bird flu history of the last four years: Bird flu continues march 4 years later. The number of human deaths is still not large -- a few hundred -- just a day at the office in Iraq. But the virus just keeps extending its geographic range in poultry stocks and wherever it does it there is a risk of human infections. Fourteen countries so far have officially confirmed influenza A/H5N1 cases. The number of birds killed by infection or slaughtered to prevent the spread of infection numbers in the hundreds of millions. While there was a period when officials believed (hoped?) that vigorous control measures like those instituted in Vietnam would be effective in snuffing out the disease, events have proved this false. The virus has dug in and is enzootic in southeast asia, China, several countries in Africa and the Middle East, China and Indonesia. Many other countries have reported sporadic outbreaks and it is likely the virus exists in some of them undetected.

So while the media has (understandable) bird flu fatigue, those of us who follow events know this virus is still out there and each day we wait for the other shoe to drop. So far it hasn't happened. We don't know why or even whether. But it is not at all clear (and in our view not even likely) that efforts made so far to stop this virus from becoming a pandemic strain have made any difference. This is why we have advocated continued and intensified efforts to prepare to manage the consequences should a pandemic materialize.

Preparing the roof of your house for a future storm never gets the same priority as shoveling the walk from the current one and that's the situation most health departments are in. We can deplore their lack of foresight or their lackadaisical approach to pandemic preparedness or their outright contempt for taking precious resources and time to address the pandemic that has not materialized but they are in a bind. If we want them to listen and make earnest and effective efforts we will simply have to bite the bullet and fork over the resources to do so. That means we will have to spend money -- and lots of it -- getting our public health infrastructure ready and sound. We say this so often here that it must surely sound like a broken record but not saying it won't make it less necessary.

If we provide health and social service departments with the resources to do their jobs -- I"m not just talking about pandemic flu, but all the jobs they have to do -- keeping vital records (needed for surveillance), maternal child health, substance abuse, protective services, assistance to the elderly and all the rest -- they will also do what is needed in pandemic preparedness. This might be the first priorities of the flu obsessed but it is rarely the first priorities of health and social service agencies that are limping along on one cylinder.

The literal bottom line is that if we want them to do what we need them to do, we will have to be prepared to pay for it. That means we must stop cutting their budgets and start raising revenues. Yes, raise taxes. If you think you know better what to do with a $600 tax rebate than the government, fine. Go out and buy yourself a better school, better public health protection, better child protective services. If you can't do that, than I don't know how you can say you have a better claim on the $600 than your community. Complaints that government agencies aren't doing an adequate job so their budgets must be cut further are nothing but a self-fulfilling prophecy.

So if you don't want your taxes raised, don't complain when you don't get the public health protection you want. And you aren't getting it. And it's your own damn fault.

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I would add one small note to your comments. Since both you and I know the government isn't going to ante up the money, both you and the government might suggest that people use their $600 refund for personal pandemic preparedness.

Please note this news report:
"India put 26 people in isolation after they fell sick while culling poultry in a state affected by bird flu, while medical staff were monitoring hundreds of others, officials said on Friday."

"Those quarantined in West Bengal complained of fever and respiratory distress over the past few days."

Events in India and Indonesia are now moving very fast. The critical issue now is time. I do not believe there is time for health departments to get ready, even it they wanted to.
But that does not mean they should not start now. They should. But those who do not want to pay more taxes, will specify there are virologists saying the risk of a pandemic is very low, since H5N1 appears incapable of infecting humans efficiently. Very few people have died in this way. So if virologists are saying this, why would people want to pay more taxes for a problem that does not exist?
For those knowledgable of the events in 1918 leading up to the Spanish Flu pandemic, the situation now is almost like a photocopy. The storm clouds in India and elsewhere are now forming at incredible speed.
For those who read Randy's comments last night, you have some idea of how bad the situation really is.
A bird pandemic is like a giant wave that humans cannot possibly stop or slow down. As more and more cullers are exposed, the virus may adapt to humans. Culling only works when there is a small outbreak. And now there are indications the virus may have penetrated another species barrier, as more and more goats are dying in India. This should be investigated immediately. If it is true, the virus will have many more opportunities to adapt to humans.
Please enjoy this tranquil moment of calm, before the storm hits.

JohnW: I disagree. The point of the post was that if we want public health authorities at the local or state level to take pandemic preparedness seriously we have to take providing them with the resources to do their whole job seriously. That means we will have to pay for it in taxes. If you want to cut taxes then you have to be prepared to cut services and that means no pandemic preparedness.

herman: Last time I am warning you. Respect the threads here. If you want to post about this stuff independently of the post start your own blog but don't mess up the threads with whatever you want to say. It is not fair to others here and I won't permit it.

Actually John's suggestion has some merit. If the rebate were in large part food stamps it would increase the likelihood of buying American, stimulate the economy and, with an appropriate ad campaign used to increase food prep. However, I agree with Revere as well. At some point we are going to HAVE to increase taxes. Public health is sinking into obscurity. The piper is demanding payment and I for one fear losing my children in exchange for ridding the town of rats or, in this case tax dollars.

If you think you know better what to do with a $600 tax rebate than the government, fine.

Given what I regularly see our government throw money down the toilet on, I do frankly think I could make better use of it.

If I thought that the money would go to an honest, competent public health effort, I'd be all for it. Instead it'll get spent on bridges to nowhere, subsidies to already indecently prosperous industries, NASA's moronic new Ares rocket, midnight basketball, faith-based chastity programs for horny teenagers, the V-22 Osprey, and other such amply documented stupidities.

It's not that Big Government is bad. Some countries do a reasonably good job with Big Government. America, regrettably, is not one of those countries, and may never be. American culture is poorly suited to it. Our political system is set up incorrectly for it. The Founding Fathers never imagined a federal state with the omnipresent power and groaning weight of the one which has evolved over the centuries. Had they done so, they surely would have designed differently.

Let me argue another angle. Chris Dodd is suggesting that the stimulus package be devoted to spending on infrastructure instead of on tax rebates. I am a nerd, one who for fun reads things like long, boring policy wonk reports from the American Society of Civil Engineers. I agree one hundred percent that US infrastructure is no longer at First World levels. We are living off of decaying, crumbling capital investments made three and more generations ago, with systems that were never meant to have been in use for as long as they have.

So if I thought that our current political crew would invest wisely and well in infrastructure, I would be all for it. I have zero expectation that they can or will do so. What was the last big infrastructure project before the Alaskan bridge to nowhere? It was Boston's Big Dig. Laughably behind schedule. Disastrously over budget. Afflicted with lethal defects like falling tunnel tiles. And, the latest studies show, essentially ineffective in quelling Boston's transport mess. The return on investment from that project was probably one of the lowest ROIs of any large infrastructure project in the entire history of the nation. And it is now proposed to hand more money to the political class who thought that the Big Dig was a great idea?

I wish that our political culture would change course towards a better, more informed, less parochial model. As a citizen political activist, I put my shoulder to that wheel weekly. Do I sense the wheel turning yet? Not by so much as a degree. It may never do so. We may just continue the present trajectory of decline unabated. Terribly sad to reflect upon, but I am at heart a realist.


marquer: I don't know what to say except you have set up a self fulfilling prophecy. We underfund government and it underperforms so we cut it more. A death spiral, which, of course is exactly what Grover Norquist wants. Not every dollar spent will get you full value. You'll fund some pork and some stupidity. Just like Comcast and Raytheon and our health insurance dollars, 30% of which go to pay people to deny us coverage.

We can afford much higher taxes than we pay and many people would be glad to pay them if we got something for them (instead of bombs killing children in Iraq). But the only way to get this is to fund public health and the other infrastructure projects our communities depend upon. That's it. Like it or not.

FWIW-I am torn between two ideas here. Revere makes sense but even if we gave the money to the government (you know, that group that thinks the money in your pocket belongs to someone else) what really could they do with it to stave off disease? Revere except to beef up the PHC system by 600 bucks per person for what, one year what would it really do? Taxes are perpetual and so are the bureacracies when they are put into place. I rankled you that the CDC was hit so hard... Hell, I couldnt tell what those people ever did for the last 30 years that improved anything. Andrew Speaker was a good example of that and it was with the blessing of his soon to be father in law. The countries in question sure had a problem with it even if the CDC didnt.

If you will build it they will come, and they will come in droves. There is no indication that even throwing money at the problem of panflu would or has helped except minimally. Tamiflu is taking a major hit in the mainstream news today...Roche/Gilead are going to take hits for sure. So that one is soon out. Cant make a vaccine for all the reasons already known. Sure cant produce it in the US due to litigation problems. Even if we did it likely would be pretty rough on humans and there are no guarantees you wouldnt have the usual problems with vaccines that are introduced.

So we go back to square one and head off in the direction of personal preparedness. You are looking out for yourself and maybe one or two others. As long as a fire doesnt happen, and the power doesnt go off, and the gas isnt cut you might have a fighting chance with wave 1 or 2. By personal preps you might just be getting hungry at the time that a 4 month event ends. Many others would likely not make it past 2 months. 600 bucks for food preps... now thats something I can get into.

Revere-Other than the upsetting of the apple carts at NIH and CDC what would you have them do? Really?. Increasing their budgets so far isnt an answer. We have XDR-TB, Polio popped its head up in Pakistan two days ago, pollution still invades the environment and it was happening under WJC's watch too when all of these budgets were loaded with money. Raising taxes to do specifically what? I cant see that anything we have done across the last 40 years has done a thing to improve public health. It has left many people thinking that its a right. And THAT is the biggest problem out there. IMO if it were in place during a pandemic it would decimate a UHC system. It would put it under completely and then what? The lawsuits for not receiving care at all would flatten us. You paid for it, you showed up and you died waiting...Cant go with the extraordinary situation clause there... they know/knew it was coming.

You all know my doubts about UHC. Right now due to the seasonal flu schools are closing and the doctors offices are already full. What would be the effect if we did put the money into PHC? Its conjecture of course but two years ago during flu season California's near socialized medical system for the state nearly went under due to the crush of illegals and people that were in it. They raised taxes to pay for it. Now they have to cut it again because it is killing businesses.

Budgets? We can raise taxes for sure... but to what end? The results are the same in the run of the entire gammete. We had an initial group of successes in the 60-70's when those programs were bloated with money, we were financing welfare cadillacs and government was the largest employer in the US. It became an endless tax and spend mill and produced nothing but a few that crossed the line from poverty into productivity. That was cut and all sorts of new jobs came alive in the 80's and into the 90's. Unemployment for the year of 07 ended on a 3.9 to 4.3 note depending on who you talk to. Now you suggest we increase taxes and do specifically what? Will the number of outcomes change significantly if we do? It didnt so much in the 60-70's, it didnt in the 80's, and above all it it didnt in the 90's. So what would Revere specifically do?

By M. Randolph Kruger (not verified) on 01 Feb 2008 #permalink

Randy: I'm talking perpetual, not just one time. You get what you pay for, or more accurately in this case, you won't get what you don't pay for. The $600 was just to signal that the proposed stimulus taz rebate or a tax cut that produced the equivalent amount in my pocket each year wouldn't do much for public health, police, fire or anything else. Some things you can't buy on your own (and when you do you pay more for them). You have to go in with your friends, aka, your community. That's what taxes are.

I'm laughing my tush off at Revere insisting we must start throwing additional money at the government. They should start doing something about their waste, fraud, and corruption. You're doing the same thing as a doctor advising a family that their 300-pound couch potato son is obese and unhealthy because he isn't getting enough food.

By speedwell (not verified) on 01 Feb 2008 #permalink

speedwell: OK. Don't complain, then, when they don't do anything for you. Except send your tax money up in smoke. Unfortunately I can't do much about the private monopolies like the insurance companies and utilities that waste my money even more but that's life.

But I agree about the obesity part. I'd flush the Defense budget by 75%. Lots of fraud, waste and corruption there, for sure. $500 billion next year. And that's without Iraq and Afghanistan. So you and I agree about that, anyway.

Refusing to fund government because of earmarks strikes me as ludicrous. Earmarks have a relatively small impact on the government compared to military spending. And in fact some of the earmarks actually go to military purposes.… In 2007, [snip]Congress has revealed close to $80 million in earmarks boosting spy technology and training as part of the 2008 defense appropriations bill.

Military spending constitutes over half of the budget. Instead of giving our hard earned dollars to Pakistanis and the corporations who manufacture everything from insect sprays to shoelaces, why don't we instead give it to Americans? What a novel idea. We can't afford to fix our roads because toilets in the defense spending cost over $1,000. Not that really do of course, that money actually is sent to secret locations to fund things you and I aren't supposed to know about. Our priorities are screwed up. What brought down the Russians? We bankrupted them. We drove up their defense spending to the point it wasn't sustainable. And we are doing the same thing to our own economy.

So the next time you scream about pork, remember in the scheme of things it is a hill of beans compared to the volcano of defense. If you really want to see improvement, then vote for someone in the next election who is going steer the government away from military entitlements and towards roads, bridges, and health care.

All I'm saying is that they can do all they need to perfectly well if they start exercising the same diligence and frugality that any ordinary functioning person or business does. I don't see why I have to stop complaining when they can't do their job that we pay them a pretty penny for.

By speedwell (not verified) on 01 Feb 2008 #permalink

speedwell: Really? And how do you know this? I know the problems health and social service departments face and it is uphill all the way. As for paying them a pretty penny, surely you jest. My daughter is a social worker and I don't think you could live on her wages. Instead you'd rather pay for the CEOs of failing companies the Bushies have handed over our tax money to under privatization? LOL.

OK, it's your blog and I don't want to make a scene, but I know that you are perfectly aware that good intentions don't mean diddlysquat if they don't produce good results. I'm sorry your daughter is trapped in an inefficient bureaucracy that is the very definition of "good intentions," but if you mean to contend that her virtuous poverty and sacrificial suffering actually do anyone any tangible good, I think you have a lot of demonstrating to do.

By speedwell (not verified) on 01 Feb 2008 #permalink

Oh, and why do you assume I want to pay for CEOs of any companies, successful or unsuccessful? (Because if a company has money, I'm sure the CEO will take care of himself without my help.) And how do you know I couldn't live on your daughter's wages? (Because I've been poor before... I know the ropes... and I still live very frugally.) And exactly how long have you been stalking me to determine my political positions? (Because you're doing it wrong, as the LOLkids say these days.)

Oh, and we (collectively) pay the government (on the whole) a pretty penny (in the form of taxes). I would have thought you were smart enough to catch that, but you're too worked up at the moment. Sorry I sort of hit your political funny bone. I'm sure your other readers are tired of this. Why don't we take a breather and come back to this topic another time?

By speedwell (not verified) on 01 Feb 2008 #permalink

I can assure you of one thing and that is if the money is in their hands its never handled well and that includes everything outside of the government. The Bushies havent handed anything over that we didnt want them too. It limits the size of government Revere. Your suggestion is that we increase that burgeoning US government with more US Government? Explain that.

How our tax dollars are spent Shannon? To me unless someone is totally indigent, they should still have to pay for their health care, their homes, their cars, their food... just like me. We need old people casualties right now to keep the system solvent. Time to acknowledge that we are not going to be able to pay for all of this stuff w/wo the military and you have to have domestic stability to have an economy...Translation? Military comes first ahead of the people.

I looked at your graph Shannon and its the typical biased based pie chart. Its like the spending thats done on defense being wrapped in with this much for Afghanistand and this much for Iraq. Thats not the way it works. You can separate the costs of doing business in that land but not the total military infrastructure. Take away that spending for Iraq and Afghanistan and you would still have a military and a military engaged in both countries.

Lets see now, Clinton cut the size of government by 500,000 jobs during his tenure. What he didnt say was that it was the size of the military and that was mandated as the peace dividend by Congress. He replaced them with government programs and spending which equated to new taxes. Support services and forces numbered about 2 to 1 into the field so yeah, he cut it hard. Then? We had a recession as he raised taxes and the interest rates rose because we cut spending on one hand and just increased it on the other. Pure smoke and mirrors and it turned money to the programs that Revere wanted. Fine and good. But it didnt change anything and because of interest rates and taxes it had the wrong effect. Economy killers.

What people fail to understand is that each time we have cut the military, we have cut our throats in the wars that followed. Iraq? We would have been back in there anyway. Afghanistan... hot bed of those who would kill us. So you guys can bask in the glow of health care if it comes for a very short time. You will need that healthcare if we cut the military. Its pretty simple. Its not a slam against you Shannon or Revere. I would absolutely love to be able to say that people should be able to retire at 65 and live until 90, but its just not possible. They need to be dying and not living longer. We have a 10/12 to 1 ratio for future payers against payees in 2012. Social Security alone is a disaster and taxes are going to rise as a result all by itself. We stole the money and now we gotta pay it back. Add in Medicare or UHC complete and this will account for all of the tax dollars taken in even if we raise taxes by 30%. Its an arguable number of course and Revere thinks that the rich dont pay enough because they are productive. Thats the problem with progressives and their ideas of progressive taxes. Those "rich" people will just sit back and quit spending and creating jobs by doing so. The economy tanks for four years until they can vote the bums out.

But what is rich? Rich, and this is no poop was under the Clinton plan for health care a single mother of 2 with an income of 50,000. She is paying 25-30% now but Revere thinks she can pay more. I think not. HillaryCare.... cradle to the grave. All paid for by whom? .

This redistribution of the wealth thing is crap. Its a bunch of people who think that the money that someone else earned by whatever legal means is immoral. Especially if its a lot of money. Its like compensation at those corporations... Its not us deciding what they'll get paid, its their boards. They can always just say no and pick someone else. So far its been pretty good with a lot of abuses that cost stockholders (Bernie Ebbers-WorldCom). But the bottom line is that it leads to this class warfare crap and its getting old. Why shouldnt we have a strong military even with the waste, fraud and abuses. Its age old and part of the Johnson good ole boy network plan of everything is "lets make a deal."

Should we drop the military in lieu of healthcare. Well if you want to lose more embassies, have our sovereignty challenged on all fronts and of course, get our asses kicked in some pissant war like Vietnam, sure. Naked open aggression and forced submission of an enemy in war is what has to be done if you want to win.Cant do it without the forces. There are no open armies for the time being to deal with other than Russia and China. Keep an eye on the Chinese who are buying up French made systems to the tune of 18% of GDP a year. We are peanuts by comparison. If the Red Dragon starts a march, we would be forced to use nukes if it came down to it. Move us under the nuclear umbrella by defense cuts and its assured that the only thing we can do is use it to stop them. I also can assure you of one other thing. Watch for the day that the Chinese announce that they have a missile that can hit New York or anywhere on the globe and within a month or two they'll start pushing. But this isnt a problem with the socialist/progressives.

75% cut to the military Revere? I guess the Boston Tea Party was run by a couple of left wing liberal surfboarders in from Redondo. As for our enemies, what would you use on them if this happened... harsh language?

So decide. Healthcare or defense. Our way of life or socialism/communism that will result in the destruction of the US. Revere has already posited that we will be disintegrating as a nation. To me its a no brainer as to what to do.

By M. Randolph Kruger (not verified) on 01 Feb 2008 #permalink

speedwell: You miss the point I was making. I was countering your claim (and my daughter is not at all unusual) that those struggling to provide human services are making a pretty penny. On the contrary, it is a good way to go broke. Bright young people don't stay in institutions where the tools are taken away from them and they get no respect. So the public health and social services infrastructure are a shambles and a population who really pays comparatively little taxes and doesn't want to sacrifice a thing for anyone else then complains about government while allowing themselves to be taken to the cleaners by big corporations who are taking money that could go to taxes to help everyone. I pay more now on my own hook and user fees than I did in taxes in the nineties.

Randy: You want to hand three quarters of a trillion dollars over to the Pentagon to "use wisely"? I know you are ex-military but this is so far beyond the pale it is almost inconceivable. Why do we assume public health won't spend money well but the military and all those defense contractors will? If you are going to cut public health, then let's also cut the military so we can lower taxes that way, too. Is it all about whose ox is being gored?

Randy, I choose health care. I am tired of being told to be fearful and, we need to spend vast sums of money to protect us from a handful of terrorists. At this rate we are all going to end up as the Spanish did after conquering South America. They bankrupted themselves trying to fight other Europeans after stealing everything they could get their hands on in the New World. The Russians went belly up at the end of the Cold War. The Germans went belly up-twice. They managed to learn not to race to war-we have yet to learn that lessen. Somehow, the rest of the Western world and a growing segment of the Eastern one as well, manages to feed their poor, offer health care and a host of other services, while we squander our money on an ever ballooning and no-end-in-sight fight against? I forget why and who is it we are trying to kill this week? If we stopped acting like bully's, perhaps the 90lb weaklings will stop trying to kick sand in our face. In any case if we keep our present course, we are rocketing into insolvency. And we are doing it at the cost of thousands of hungry children, people in the middle class dying needlessly from treatable ailments that they can't afford, and veterens living under bridges unable to get treatment. Now tell me again my priorities are misplaced.

Max: You'd need to have vaccine productive capacity for twice as much vaccine (meanwhile neglecting the seasonal vaccine) AND a functioning public health system to deliver it. We don't have any of those things and aren't likely to at the rate we are going. We are stripping ourselves of that ability instead.

A story quite pertinent to this discussion has just been published by the Washington Post:…

"The federal government's voluminous plans for dealing with pandemic flu do not adequately account for the overwhelming strain an outbreak would place on hospitals and public health systems trying to cope with millions of seriously ill Americans, some public health experts and local health officials say."

I certainly agree that there are many areas of public health that are underfunded. However, I disagree that this is entirely the public's fault. As others have pointed out, some of the money allocated to public health has been misallocated. At the CDC, money was spent on an expensive gym with pastel "mood" lights and zero gravity chairs. You can say that this represents a very small portion of the CDC's budget, but misallocating money in this way makes the CDC's budget an easy target. Further, there is an interesting discussion at CDC Chatter about how (very large) bonuses were distributed. Sounds like the people doing the most damage are being generously rewarded.

At the state level, the heads of the public health departments are rarely the most qualified, imo. Instead, they are political appointees. Although some of them mean well, and some of them happen to be competetent, the overall system is disjointed and very poorly ogranised. I say this based on my examination of the websites of very state public health department and every state pandemic plan. As near as I can tell, there are no national standards for how these departments should function.

The rubber meets the road at the county level. These are often the people who actually have to serve the public. And it is true, they are under-resourced. Some of them are doing the best they can under difficult circumstances and I truly sympathesise with these individuals. However, I would suggest that as long as they are under the thumb of political appointees who are often incompetent, it will be difficult to garner public support for public health.

Pixie-Yeah I read that. Thats about as good a description as I have seen on it. It mimics those shitty questions that I ask all of the guys that are supposed to be smarter than me on this. I get about the same answers as what was seen in the Post.

But really, what can they do? Pandemics start when there are unknown bugs running around no vaccine or no treatments. Its like going to a surgeon for the answer to a problem. The surgeon wants to cut, the MD wants to give you a pill, the oncologist radiation and chemo. But no one gets cured. Its all wrapped up into one big ball and the one thing that is sure, a high CFR bug will take the system apart like a two dollar watch. So again how much money could there ever be that was used in public health that really would change any of the outcomes for a super-bug. For the last six months H5 at least has been almost 100% fatal with every device and med available and recommended for the treatment. Didnt work out and certainly I can account for I think two people? that made it. Not many.

Its all about the level of peace you want and what you want to pay for. UHC or defense. If someone is driving through the streets of Canada on their way South I dont think we will be worried about public health. Its a poor analogy but indeed a like scenario happened with Daniel Ortega when Gorbachev was being deposed. He sent 400,000 troops north into Nicaragua with the idea being to run refugees north into Mexico and then on into the US. Our liberalistic country would have tried to take care of them. BTW that would have been something on the order of 20 million. Now we have 13 million and anyone think thats NOT a problem.

Its all about the toys. Revere has his medical toys that increase the life expectancy but at age 65 you park it for the better part thus putting the UHC money into the ground when they die. OTOH the military makes sure that we dont get hit by active armies and they dont do it like Obombme suggested and that was the strafing and bombing of innocent women and children. But I do see what he wants to do. I just see no way to pay for it realistically. If they tax and spend you get more people. We need fewer older ones to reduce the load on the system. Thats not mean spirited but increasing the life of someone who is past 65 by mandated law of the S.Security system is like screwing for chastity. Its pure economics plain and simple. Old people need to shuffle off or there is going to be a huge debacle in this country in something under ten years. Not enough taxpayers, the cost of living will rise as will inflation. How and who is going to pay those UHC bills. No, not the oldies. So it will be based on income as usual. There arent enough rich people in the US to pay for a system that they want and to tax for. You pay in? Shit what if you got no money in your pocket after you pay in. Then what?

This battle has raged ever since man was able to feed himself. One develops something neat, the other one wants it. They get it by whatever means possible. The military does it with their toys, the medical types get it with theirs. Now the libs want a cradle to the grave. They put this in, euthanization of the elderly and mindless might just be around the corner due to costs. This is the reason the founding fathers said a limited government and not one that keeps creating unproductive bureaucracies. Kill the businesses, kill our economy. Think not? Drive to Detroit where the state taxes alone made them uncompetitive, adding in the Federal taxes it simply put them over the edge.The last nail? The unions.

But fear not.. I am sure Hillary and Obombme both have a plan to pay for all this crap they are offering up as carrots.

By M. Randolph Kruger (not verified) on 01 Feb 2008 #permalink

Correction to the above, "sent north into Honduras from Nicaragua"

By M. Randolph Kruger (not verified) on 01 Feb 2008 #permalink


I look forward to reading your posts. Invariably they ring a bell. You are right. I agree that Randy has the pulse on this debate.

Personally, I agree with revere, but with a big caveat... I'd spend the money at the state level, where it would be put to better use. They're the folks who could get the kid with bipolar disorder out of the emergency room (where they've been sitting for 2 days for lack of a facility) and into a hospital bed, not the feds. They're who does local surveillance. They're who need panflu prep funds.

And so on...

Dem-but again if there is chaos in the streets what good is a health care facility? I have been in some really crappy areas of the world and the "line" as I used to call it was tromped on by both sides. That line between anarchy, chaos, liberalistic ideals being applied in a war zone is very, very thin and its a lot closer than anyone thinks at any given time. Look at what happened. We cut the military in the 90's, then we got into a pair of wars. We provide health care or really any bigshit government program we have to cut the military to do it. The answer? Raise taxes. Uh-huh. No economy then and back into the spiral of inflation that plagued us from the 60's into the 80's. I knew what inflation was during the 4th grade. The spiral is there waiting to happen. Putting money into health care means free for someone at the expense of someone else. That is legalized theft. Revere says the same thing about the military but the military is in the Constitution. Nothing there about entitlements or health care.

The idea was before Iraq that we needed to be able to fight a sustained 30-60 war on three fronts. Not able to do that unless the enemy is visible. We have also already shown that its not possible to do it. There are those that are already trying to minimize the threat from Al Qaeda and others to the US in an attempt to constantly barrage Bush. Thats a load of crap. My little friend Hugo Chavez has set up training camps in his country for them and that was in the NYT. They arent there because they like the weather. You have seen me post about how many Arabs are changing their names in Texas to Hispanic ones. Coincidence? Hardly.
They can attack at will. Without a military that is strong and robust we are done. How about a 9/11 a week? How about creating a military state in the US if it happens? I like that lightning rod over there... Keeps them busy. But they are changing tactics. Canada is registering a lot of Arab names being changed to French and Hispanic. Must be for what?

Look the signs are there. What does it take for everyone to get it that health care isnt the issue? Its not an implied threat thats presented either. They mounted an attack on New York after we "negotiated" for the release of their main terrorist M. Atta from Israel. Israel did it in good faith and one crapload of people died on one sorry afternoon. If Hamzi and others had packed about another 10 pounds of explosives into a van they would have brought the WTC's down during Clintons watch. This is a war, its been going on now for some 17 years. We are just too dumb here to get it. Had we gone after them under Clinton we might have been finished now. But that didnt happen, here we are in Iraq and the question remains whether the Iranians are making bombs. One underground test and they are toast.

There are a lot of other developments that havent hit the papers yet. We can talk about those when they are leaked by some Senate member....Leaky Leahy? .

Truth is we can sit back and take hit after hit with all of the noise that goes with it. It will have some economic effect unless its a whole city. But do we want to? I would have done it a lot differently and non-Vietnamed it. ARC LIGHT them and all around it for five miles. They hit us, we hit them ten times over. We drive it right home that the punishment for attacks is death on a huge scale. Screw me. Its like Vietnam now, we started a war and the politicians wont let us finish it. We either keep them tamped down or sooner than later a nuke will go off and between 18-30 minutes later there is going to be a great smoking hole where a city or country used to be. If they hit us they'll probably try for Washington.... If they take it out, government efficiency will probably rise 300%.

Domestic security comes with a price.... Its a war footing we are one and we are on it for the foreseeable future because there are legitimate threats. The Taliban are regrouping in Afghanistan. They and Al Qaeda are trying to destabilize Pakistan and if they get their hands on nukes, India might go for the pre-emptive strike. Then the whole place goes up in flames. Meanwhile, we sit here and worry about someone who doesnt have health care.

We worry about the micro problem of healthcare. Its macro for some but the people can get healthcare if they need it. They dont like hoops. Who does? We all have to jump thru them though. We get this other part wrong regarding the military anywhere in the world and hundreds of thousands will die. Millions if its the US east coast. We all know the scenario and yes it could come like a script out of a playbook. Our response would be canned, decisive and it could start WWIV. Nothing would make Al Qaeda happier than to set off a nuke in NYC and place the people responsible right on the border with Iran and Russia. Our response because we dont and wouldnt have the forces to fight our way in conventionally would be to pop them back with a tactical or strategic weapon. The radiation would drift into Russia without a doubt. Think that might piss them off?

This is the nuclear umbrella thing that I speak of. It keeps the non nutcases like China and Russia at bay. But if its our only response and we have to step up, dust it off and use it then it will INDEED be a rainy day. Health care be damned after that.

Me? I get to watch the rockets red glare when it happens and not have to worry about the health insurance payments any more, along with 300 million other souls in the US. This isnt intended to be mean spirited in any way but it goes back to what I said. Its a doctors response to one aspect of our life style in the US. If you dont have domestic security you couldnt treat a sick cat. God love you guys for wanting it. Hell, I want it too but there is no way to pay for it and keep an economy going.

I do agree that the states should get more money for panflu. But its like I said though... for what? Nothing they have done so far can be attributed to any survivors outcomes other than to not get it at all. There is a HUGE compensation program out there if bird flu comes to the US for the poultry industry. It goes to the owners of the corporations and not to the people who worked there. If we spend what the program says it will triple the national debt to cull 1/2 of the chickens in the US. I am working now to get that stopped. They COULD spend that money on panflu preps more effectively. What? We end up with live chickens and corporations but no people to eat or support them?

And the beat goes on.....

By M. Randolph Kruger (not verified) on 02 Feb 2008 #permalink

I am working now to get that stopped. They COULD spend that money on panflu preps more effectively. What? We end up with live chickens and corporations but no people to eat or support them? And the beat goes on.....

I'm with you there. I just have an HHS/public health and not a DHS sensibility. I fear natural disasters more than man-made ones. i look to quanantine as voluntary, not mandatory, and so on.

And the thought is that not only is health care far more a concern of Americans than terrorism or immigration issues (economy, iraq, health care in that order) but that rebuilding infrastructure helps with everything, in the event life goes on as usual nationally (a far more likely scenario than a terrorist attack, which horrific as it is, is more local).

Sen's Corker and Alexander from TN are with you on that Dem. Funny thing? Cant even get an appointment with the Dem delegation... go figure. You also know something thats not funny about the whole deal? Its like a patron who goes to a whore house for a solid year and then comes back to tell everyone he has AIDS.

The two parties simply will NOT work together. More so they wont talk to each other either. Frist left because as they say he was tired of the politics. He was selected by the Republican Caucus to be President nearly three years ago and he left. He tried for another 500 million but was blocked by both sides of the aisle.

Hopefully he will run for Governor. Hang in there Dem...We push long and hard enough we can deflect the asteroid.

By M. Randolph Kruger (not verified) on 02 Feb 2008 #permalink

I live in a rural area where a lot of people raise chickens, usually for the eggs, but often just as pets. I was talking with one of the chicken farmers, a retired MIT trained naval engineer, and he was concerned about bird flu, what with all of his chickens. He called the Washington State agriculture department and it turns out that they have plans and funding. If one or more of his birds dies mysteriously, they want to test the carcass. They have funds, and they are hoping to catch things early. He, and we, were relieved to hear this.

Also, there is a common illusion about who money belongs to. If you actually have ever seen any money, particularly U.S. money, you will notice that it says United States of America all over it, and it has facsimile signatures from a number of government bureaucrats printed on it. Sure, I get to use them, but U.S. dollars belong to the U.S. government. I'm not sure of how this works in Europe, what with the euro and all those national governments, but I'll bet it's pretty much the same. (It's like this with land. I may claim ownership, but it actually belongs to the U.S. government. They even have an army to protect it, so when someone says "You and what army?", I'm all set. People who want to really own money or really own land have to get their own printing presses, federal reserves and armies).